AB1191 FACTORS ASSOCIATED WITH WALKING SPEED IN PATIENTS WITH END-STAGE KNEE ARTHRITIS WHO ARE SCHEDULED FOR TOTAL KNEE ARTHROPLASTY
Authors: S. Yamada, T. Ikawa, K. Mandai, S. Maeda, T. Hashimura, T. Tachibana, H. Ohashi, I. Kentaro
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with knee joint disorders have impaired mobility, which interferes with their daily lives, resulting in frailty. Various factors are assumed to contribute to the decline in walking speed, which is an indicator of mobility. <h3>Objectives</h3> In this study, we measured the gait speed of patients scheduled to undergo initial total knee arthroplasty (TKA) and examined the factors that correlate best with gait speed. <h3>Methods</h3> Patients with end-stage knee arthritis who underwent initial TKA at our hospital between July 2020 and October 2022, and whose gait speed was measured before surgery with written consent, were included in the study. We investigated the relationship between basic attributes such as age and gender at the time of the survey, pain VAS during walking, clinical evaluation of knee joint function (Knee Society Score: KSS), skeletal muscle mass of both lower limbs (whole-body mode Dual Xray Absorptiometry method), quadriceps muscle strength (flexion and extension strength by dynamometer), and range of motion (degree of flexion and extension), frailty, sarcopenia. <h3>Results</h3> 210 subjects (170 women, mean age 75.5 years) were included in the study. Multivariate analysis was performed using walking speed as the objective variable and age, gender, VAS for pain during walking, KSS, skeletal muscle mass of both lower limbs, quadriceps muscle strength(flexion and extension strength), range of motion(degree of flexion and extension), frailty and sarcopenia as dependent variables. The results showed that age and walking pain VAS and KSS were significantly and independently associated with walking speed (P=0.01, 0.04, 0.05). Gender, skeletal muscle mass of both lower limbs, quadriceps strength (flexion and extension), range of motion (degree of flexion and extension), frailty, and sarcopenia were not found to be significantly associated with walking speed (P = 0.79, 0.13, 0.65, 0.21, 0.68, 0.74, 0.34, 0.20). <h3>Conclusion</h3> Age was found to correlate most with walking speed, with walking speed slowing with increasing age. A correlation between lower quadriceps muscle extension and lower walking speed has been reported previously, but this study did not correlate. Nor did it correlate with lower limb skeletal muscle mass or range of motion. Pain during walking was observed in many cases, so it may not have been significant. <h3>References</h3> [1]Oiestad BE, et al. Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis. Osteoarthritis Cartilage. 2015 Feb;23(2):171-7. [2]R.S.Husted, et al. The relationship between prescribed pre-operative knee-extensor exercise dosage and effect on knee-extensor strength prior to and following total knee arthroplasty: a systematic review and meta-regression analysis of randomized controlled trials.Osteoarthritis and Cartilage.2020 [3]Min Ji Suh et al. Bilateral Quadriceps Muscle Strength and Pain Correlate With Gait Speed and Gait Endurance Early After Unilateral Total Knee Arthroplasty: A Cross-sectional Study. Am J Phys Med Rehabil.2019 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.